HomeMy WebLinkAboutFilled Land Affidavit PIw;ANNING&DEVELOPMENT SERVICES DEPARTMENT
III Building&C94ejUgulations Division
2300 Y`tEL NIA AVEMJE
FORT`PIERCE.FL34992-5652
(772)462-1553
FILLED LAND AFFIDAVIT _
l
.t,the unders'Igned,am the owner of the:fnllo*ing described property;
(Parcel.I0/l egal de3criodon/Address)
for which .I have applied to.St. Lucie County for a Final.'Development Permit: In_
accepting this Final Development Permit, BP Number_ , I acknowledge
that as owner of- the above. described property, and in accordance with Section-. ,
7.04.01 County � g r i g.
(D) St.Lucie Coun Land Development Codex I.shall be nsible for assurm -
adequate drainage so that:the immediate community°WILL NOT;be adversely affected:
I further acknowledge that in grauting.this permit for the developmeO of this property.,
St. Lucie County is neither.obliged nor liable to provide for; or maintain in any form,
adequate drainage off my property. which will not adversely affect the immediate.
community.
P" er Name(Please )
r ..
pat es SiEnature D*
STATE OF FLORIDA,COUNTY OF
/&Co
ACKNOWLEDGED BEFORE ASH THIS DAY OF 20
-n WHO IS PERSON Y KNOwN O,.ME`-(Lj)OIL WHO HAS -
PRODUCED AS'IDEN IFICATION.
ellSIGNATURE OF NO Y PUBLIC tl7ftbR PRINT NOTARY'
COMMISSION NUMBER
(SEAL)
SI,CPDSD Revised 04n.11201,1
AUDREY B.HUMPNREY
MY COMMISSION#GG 359817 .
EXPIRES:March 6,2023
FOF Flo Gonded Thru Notary Punks i!nderviriters